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The US House of Representatives chamber after the healthcare vote - Source: Reuters -
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The US House of Representatives gave final approval to a
sweeping healthcare overhaul, expanding insurance coverage to
nearly all Americans and handing President Barack Obama a landmark
victory.
On a hard-fought 219-212 vote late on Sunday, House Democrats
approved the most dramatic health policy changes in four
decades.
The vote sends the bill, already passed by the Senate, to Obama
to sign into law.
The overhaul extends health coverage to 32 million Americans,
expands the government health plan for the poor, imposes new taxes
on the wealthy and bars insurance practices such as refusing to
cover people with pre-existing medical conditions.
Its passage capped a year-long political battle with Republicans
that consumed the US Congress and dented Obama's approval ratings,
and fulfilled a goal that had eluded many presidents for a century
- most recently Democrat Bill Clinton's failed attempt in
1994.
"Tonight, at a time when the pundits said it was no longer
possible, we rose above the weight of our politics," Obama said
during a late-night appearance at the White House.
"This legislation will not fix everything that ails our healthcare
system, but it moves us decisively in the right direction. This is
what change looks like," he said.
House Democrats hugged and cheered in celebration as their vote
count hit the magic number of 216, and chanted: "Yes we can."
Every Republican opposed the bill, and 34 Democrats joined them
in voting against it.
Republican and industry critics said the 10-year $US940 billion
bill was a heavy-handed intrusion in the healthcare sector that
will drive up costs, increase the budget deficit and reduce
patients' choices.
Both parties geared up for another battle over the healthcare bill
in the campaign leading up to November's congressional elections,
and opponents across the country promised to challenge the
legislation on the state level.
The healthcare revamp, Obama's top domestic priority, would usher
in the biggest changes in the $US2.5 trillion US healthcare system
since the 1965 creation of the government-run Medicare health
program for the elderly and disabled.
It would require most Americans to have health coverage, gives
subsidies to help lower-income workers pay for coverage and creates
state-based exchanges where the uninsured can compare and shop for
plans.
Major provisions such as the exchanges and subsidies would not kick
in until 2014, but many of the insurance reforms like barring
companies from dropping coverage for the sick will begin in the
first year.
Heavy lobbying
The vote followed days of heavy lobbying of undecided House
Democrats by Obama, his top aides and House leaders.
The narrow victory was clinched earlier on Sunday by a deal
designed to appease a handful of Democratic opponents of abortion
rights.
Under the deal, Obama will issue an executive order affirming
government restrictions on the use of federal funds for abortion
would not be changed by the healthcare bill.
That pledge won the support of Representative Bart Stupak and a
handful of other House Democratic abortion rights opponents, who
had threatened to vote against the Senate-passed bill because they
said its abortion restrictions were not strong enough.
The House also approved a package of changes to the Senate bill
sought by House Democrats.
The Senate will take up that package this week under budget
reconciliation rules requiring a simple majority to pass.
The changes include elimination of a controversial Senate deal
exempting Nebraska from paying for Medicaid expansion costs, the
closure of a "doughnut hole" gap in prescription drug coverage and
modifications to a tax on high-cost "Cadillac" insurance
plans.
Republicans said they would challenge those changes in the Senate
through parliamentary points of order and believed they could block
its passage.
"Senate Republicans will now do everything in our power to replace
the massive tax hikes, Medicare cuts and mandates with the reforms
our constituents have been calling for throughout this debate,"
Senate Republican leader Mitch McConnell said.
The health insurance industry has vigorously opposed the plan, but
insurance stocks rallied late last week as investors began to
realize their worst fears had not materialized.
Pharmaceutical companies, hospitals and others will benefit from
more insured patients, and the bill does not allow the government
to cap prices and premiums, which would have hurt drugmakers and
insurers.
Opinion polls show the public also has a mixed view. While
pluralities oppose the legislation and the process has turned off
many Americans, some of the bill's individual components draw heavy
support.
Hundreds of conservative Tea Party activists rallied next to the
Capitol, waving yellow "Don't Tread on Me" flags and chanting "Kill
the bill."
Many entered the Capitol, wandering the hallways to buttonhole
lawmakers and at one point disrupting House proceedings.
The bill's final approval represented a stunning turnaround from
January, when it was considered dead after Democrats lost their
crucial 60th Senate vote in a special Massachusetts Senate
election.
But Obama and Democrats rallied last month for a final push, and
will use the Senate's budget reconciliation rules to bypass the
need for 60 votes on the changes they sought to the overhaul.
